Outline

Despite of the well known advances of the endoscopic techniques, only recently single reports have been published pointing at the orbit as a target for endoscopic surgical intervention using both transnasal or external approach.

In this contribution we would like to present the results endoscopic surgery in 32 patients with various intraorbital pathologies. All patients were operated by a co-working team of ENT surgeon and neurosurgeon using image guidance neuronavigation system and intraoperative ultrasonography for precise anatomical orientation. Transnasal endoscopic transethmoidal or transmaxillar approach were chosen for biopsy of intraorbital mass lesions, removal of medially located intraorbital tumors and foreign bodies, drainage of intraorbital (including intraconal)hematomas and abscesses, repair of blow out fractures. External endoscopic precaruncular, lateral retrocanthal, inferior preseptal and transconjunctival approaches were used for resection of orbital tumors and optic nerve decompression in the region of orbital apex.

In all cases the goal of the operation was achieved i.e. biopsies were taken from the central, representative part of the pathological mass, tumors and foreign bodies were removed, orbits were decompressed by successful drainage and fractured walls of the orbit were reconstructed. In few patients transient aggravation of ocular symptoms like diplopia or ptosis was observed in immediate postoperative period but they resolved completely within the first 2–3 months after the surgery.

In spite of anatomical limitations the orbit can be explored with endoscopy but the operative technique is rather demanding and satisfactory results are to be obtained only with extensive surgical experience supported with high quality equipment.

Supported by: This work was supported by grant No 13-0037-10 from the National Center of Research and Development (NCBiR)